Postmortem Antigen-Detecting Rapid Diagnostic Tests to Predict Infectivity of SARS-CoV-2–Associated Deaths

Heinrich, Fabian; Schröder, Ann Sophie; Gerberding, Anna-Lina; Gerling, Moritz; Langenwalder, Felicia; Lange, Philine; Heinemann, Axel; Bibiza-Freiwald, Eric; Nörz, Dominik; Aepfelbacher, Martin; Pfefferle, Susanne; Ondruschka, Benjamin; Lütgehetmann, Marc

doi:10.3201/eid2801.211749

Cited by 9 publications

(13 citation statements)

References 8 publications

(9 reference statements)

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“…Rodic et al reported that COVID-19 nucleic acids were identified from the lungs of embalmed corpses (7). However, viral RNA detection does not distinguish between viable and dead viruses (5, 8, 9). A persistently positive RT-PCR does not indicate whether infectious virus is still present in a person’s body.…”

Section: Discussionmentioning

confidence: 99%

“…A persistently positive RT-PCR does not indicate whether infectious virus is still present in a person’s body. SARS-CoV-2 RNA can be detected beyond the infectious period (5, 8). Therefore, detection of viral RNA does not necessarily indicate infectivity.…”

Section: Discussionmentioning

confidence: 99%

“…There have been reports of infectious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) being detected in the bodies of those who died from COVID-19 (3)(4)(5); however, it is not clear whether the virus can be transmitted from such bodies. In Japan, the most common way nurses in hospitals care for dead bodies is to wipe the surface of the face, neck, hands, and feet with alcohol-soaked cotton, in addition to taking care of the appearance of the deceased by, for example, shaving them or applying cosmetics.…”

Section: Introductionmentioning

confidence: 99%

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Can SARS-CoV-2 transmit from a dead body?

Iwatsuki‐Horimoto

Ueki

Ito

et al. 2022

Preprint

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Although it has been 2.5 years since the COVID-19 pandemic began, the transmissibility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a dead infected body remains unclear, and often, in Japan bereaved family members are not allowed to view in-person a loved one who has died from COVID-19. In this study, we analyzed the possibility of SARS-CoV-2 transmission from a dead body by using the hamster model. We also analyzed the effect of Angel-care––in which the pharynx, nostril, and rectum are plugged––and embalming on reducing transmissibility from dead bodies. We found that SARS-CoV-2 could be transmitted from the body of animals that died within a few days of infection; however, Angel-care and embalming were effective in preventing transmission from the dead body. These results suggest that protection from infection is essential when in contact with a SARS-CoV-2-infected dead body, and that sealing the cavities of a dead body is an important infection control step if embalming is not done.ImportanceWe found that SARS-CoV-2 could be transmitted from a dead body presumably via postmortem gases. However, we also found that postmortem care, such as plugging the pharynx, nostrils, and rectum, or embalming could prevent transmission from the dead body. These results indicate that protection from infection is essential when handling infected corpses, and that appropriate care of SARS-CoV-2-infected corpses is important.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Can SARS-CoV-2 transmit from a dead body?

Iwatsuki‐Horimoto

Ueki

Ito

et al. 2022

Preprint

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“…Zacharias et al (2021) reported that seven of 11 lung tissue swabs were culture positive, with a postmortem interval (PMI) ranging from 14 to 68 hours. Heinrich et al (2022) further reported that 20% of 128 SARS-CoV-2 RNA-positive corpses retained infectious virus up to 14 days after death.…”

Section: Introductionmentioning

confidence: 96%

“…Zacharias et al (2021) reported that seven of 11 lung tissue swabs were culture positive, with a postmortem interval (PMI) ranging from 14 to 68 hours. Heinrich et al (2022) further is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint…”

Section: Introductionmentioning

confidence: 99%

High titers of infectious SARS-CoV-2 in COVID-19 corpses

Saitoh

Sakai

Torimitsu

et al. 2022

Preprint

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Background: The prolonged presence of infectious severe acute respiratory syndrome coronavirus (SARS-CoV-2) in deceased coronavirus disease 2019 (COVID-19) patients has been reported. However, infectious virus titers have not been determined. Such information is important for public health, death investigation, and handling corpses. Aim: The aim of this study was to assess the level of SARS-CoV-2 infectivity in COVID-19 corpses. Methods: We collected 11 nasopharyngeal swabs and 19 lung tissue specimens from 11 autopsy cases with COVID-19 in 2021. We then investigated the viral genomic copy number by real-time reverse transcription-polymerase chain reaction and infectious titers by cell culture and virus isolation. Results: Infectious virus was present in 6 of 11 (55%) cases, 4 of 11 (36%) nasopharyngeal swabs, and 9 of 19 (47%) lung specimens. The virus titers ranged from 6.00E + 01 plaque-forming units (PFU)/mL to 2.09E + 06 PFU/g. In all cases in which an infectious virus was found, the time from death to discovery was within 1 day and the longest postmortem interval was 13 days. Conclusion: COVID-19 corpses may have high titers of infectious virus after a long postmortem interval (up to 13 days). Therefore, appropriate infection control measures must be taken when handling corpses.

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